Resumen

ARROYO, David et al. The effect of replacing aluminium hydroxide with calcium acetate/magnesium carbonate on serum phosphorus control in haemodialysis patients. Nefrología (Madr.) [online]. 2014, vol.34, n.2, pp.199-204. ISSN 1989-2284.  https://dx.doi.org/10.3265/Nefrologia.pre2013.Nov.12145.

Introduction: Calcium acetate/magnesium carbonate (MgCO₃) is a phosphorus binder with advantages in terms of cost, safety and tolerance and it has a similar efficacy to other drugs. The objective of the study is to assess the effects of replacing aluminium hydroxide [Al(OH₃)] with MgCO₃ on phosphorus and calcium metabolism in a cohort of haemodialysis patients. Materials and methods: We included 21 patients with phosphorus <5mg/dl, with Al(OH₃) as the only binder. The conversion to MgCO₃ was carried out without changing the number of pills. We recorded clinical-demographic characteristics, treatment for secondary hyperparathyroidism and laboratory parameters before conversion and every month for four months. Results: Phosphataemia decreased from 4.52±0.99 to 4.02±1.07mg/dl (p=.027), and there was a decrease in the calcium-phosphorus product from 40.20±10.44 to 35.16±11.06mg²/dl² (p=.037). We did not observe significant changes in levels of calcium, parathyroid hormone or 25-OH-vitamin D₃. The daily number of pills prescribed was reduced from 3.33±2.29 to 2.15±2.21 (p=.020). Concomitant treatments were not altered. We observed an initial significant increase in magnesaemia from 2.21±0.24 to 2.43±0.39mg/dl (p=.001), which subsequently remained stable. We found a decrease in serum aluminium from 14.91±8.55 to 8.47±3.98µg/l (p=.004), with levels within the recommended range in all patients. Conclusions: MgCO₃ allowed good control of serum phosphorus in haemodialysis patients who were previously well controlled with Al(OH)₃, using fewer daily pills. There was a slight increase in serum magnesium, without short-term clinical significance. We do not know the effects of this increase in the longer term.

Palabras clave : Haemodialysis; Hyperphosphatemia; Phosphate binders; Magnesium carbonate; Aluminum hydroxide.

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